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[Calcium-phosphorus metabolism in celiac disease in children]
G Praticò1, L Caltabiano, G Bottaro
1Clinica Pediatria II, Università di Catania, Italia.
Insights
Celiac disease significantly impacts calcium-phosphate metabolism in children, causing mineral imbalances. A gluten-free diet helps correct these abnormalities, improving calcium and phosphate levels.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Mineral Metabolism
Background:
- Celiac disease is associated with gastrointestinal malabsorption.
- Mineral metabolism disturbances are common in pediatric celiac disease.
- Understanding these changes is crucial for managing long-term health outcomes.
Purpose of the Study:
- To investigate calcium-phosphate metabolism in untreated celiac children.
- To assess the impact of a gluten-free diet on these parameters.
- To explore the relationship between mineral imbalances and potential complications.
Main Methods:
- Studied 24 untreated celiac children and 11 controls.
- Measured serum calcium, phosphate, calcitonin, and parathyroid hormone.
- Re-evaluated 16 patients after 1 and 3 months on a gluten-free diet.
Main Results:
- Untreated celiac children showed increased serum phosphate and decreased calcitonin levels compared to controls.
- Serum calcium was slightly lower, and parathyroid hormone was higher in celiac patients.
- A gluten-free diet led to increased calcemia and decreased serum phosphate and parathyroid hormone levels.
- No significant changes in vitamin D metabolites were observed.
Conclusions:
- Celiac disease significantly affects mineral metabolism in children.
- Intestinal abnormalities contribute to hypocalcemia and hyperphosphatemia.
- Elevated parathyroid hormone levels may be linked to osteoporotic lesions.
- Rickets due to vitamin D deficiency does not appear to be a direct consequence.
Abstract:
The Authors studied the changes of the main parameters of calcium-phosphate metabolism in twenty four untreated celiac children (mean age: 23.7 +/- 14.4 months) and in eleven control subjects (mean age: 28.5 +/- 21.2 months). 16 patients were checked again one and three months after treatment was begun. Compared with controls patients show at diagnosis a significant increase of serum phosphate (P = 0.025) and a decrease of calcitonin levels (P = 0.02), whereas serum calcium is slightly lower and parathyroid hormone higher with serum levels above normal range in 5 of the coeliac patients (20.8%). During the three months of gluten free diet we find a significant increase of calcemia values (ANOVA: P = 0.025) together with a decrease of serum phosphate (ANOVA: P = 0.009) and of parathyroid hormone levels (ANOVA: P = 0.042). No significant change was found in vitamin D metabolites levels. The Authors conclude that coeliac disease affect clearly mineral metabolism. Actually the tendency to hypocalcemia, due to abnormalities of the intestinal mucosa, and the comparative iperphosphatemia, cause in some patients a compensatory increase of PTH levels. This increase seems to be the cause of the osteoporotic lesions described in current literature. Rickets due to the lack of vitamin D does not occur.